Healthcare Back Office Executive

Ahmedabad

On-site

5+ years

Night Shift (US hours)

No. of Openings: 2

About The Role

Project Tree is starting a back-office service for clinics and doctors in the USA. Working from the Ahmedabad office, this role combines patient support over the phone with end-to-end medical billing for US clinics. The key mission is to code and submit claims correctly so that the clinic receives its insurance payment.

Key Responsibilities

• Call Handling & Patient Service
• Answer inbound calls from US patients, clinics and doctors professionally and resolve their queries on billing, claims and insurance.
• Record every call and its outcome in Dr Pro.
• Book patient appointments with doctors and specialists.
• Follow up with patients, clinics and insurance companies on pending matters.
• Insurance Verification & Authorization
• Verify patient insurance eligibility and coverage over the phone.
• Obtain prior authorization from insurance companies before treatment, where required.
• Medical Billing & Coding
• Pre-claim: review the doctor's documentation and assign the correct billing codes.
• Generate the bill and submit the claim with billing codes to the insurance company.
• Ensure claims are clean and error-free to avoid denials and delays.
• Post-claim: track claim status, handle denials or rejections, correct and resubmit, and ensure the insurance payment is received.
• Post received payments and reconcile them against claims.
• Escalate unresolved cases to the reporting manager on time.
• Documentation & Compliance
• Maintain complete and accurate records of calls, claims and payments in Dr Pro.
• Keep all patient information strictly confidential as per US HIPAA rules and company policy.
• Meet daily targets for calls, claims and accuracy; share daily work reports.
  
  

• Experience: Minimum 5 years in US medical billing / US healthcare back office (RCM).
• English: Good spoken and written English is mandatory, with clear telephone communication.
• Medical Knowledge: Sound knowledge of medical terminology, CPT/ICD-10 coding and US insurance (Medicare, Medicaid, commercial payers).
• Shift: Must be willing to work a fixed night shift (mandatory).
• Computer: Good typing speed; comfortable with software applications, MS Excel and email.
• Education: Graduate in any stream (Life Sciences, Pharmacy, Nursing or B.Com preferred).
• Advantage: Medical coding certification (CPC / CCS) or experience on medical billing software.
  
  

• Customer service and active listening
• Attention to detail and accuracy in coding
• Strong follow-up and problem-solving
• Ability to learn new software quickly
  
  

• Salary: No bar for the right candidate.
• Training on Dr Pro application and processes.
• Opportunity to grow with a new service line from the start.